﻿<%@ Page Title="" Language="C#" MasterPageFile="~/Progress.master" AutoEventWireup="true" CodeFile="Payment.aspx.cs" Inherits="Web_Payment" %>

<%@ Register assembly="DevExpress.Web.ASPxEditors.v10.2, Version=10.2.3.0, Culture=neutral, PublicKeyToken=b88d1754d700e49a" namespace="DevExpress.Web.ASPxEditors" tagprefix="dx" %>

<asp:Content ID="Content1" ContentPlaceHolderID="ContentPlaceHolder1" Runat="Server">
    <table style="width: 100%">
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px">
                &nbsp;</td>
            <td class="reginput" style="width: 280px">
                &nbsp;</td>
            <td>
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td class="bold" 
                style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #E4E4E4">
                CARD INFORMATION</td>
            <td class="reginput" style="width: 280px; background-color: #E4E4E4">
                &nbsp;</td>
            <td style="background-color: #E4E4E4">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; background-color: #F5F5F6">
                &nbsp;</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                &nbsp;</td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #F5F5F6">
                Card Holders Name*:</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                <dx:ASPxTextBox ID="ASPxTextBox1" runat="server" Width="300px">
                </dx:ASPxTextBox>
            </td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #F5F5F6">
                Card Number*:</td>
            <td style="width: 280px; background-color: #F5F5F6">
                <asp:TextBox ID="TextBox2" runat="server" Width="50px"></asp:TextBox>
&nbsp;
                <asp:TextBox ID="TextBox3" runat="server" Width="50px"></asp:TextBox>
&nbsp;
                <asp:TextBox ID="TextBox4" runat="server" Width="50px"></asp:TextBox>
&nbsp;
                <asp:TextBox ID="TextBox5" runat="server" Width="50px"></asp:TextBox>
            </td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #F5F5F6">
                CID*/DW:</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                <asp:TextBox ID="TextBox6" runat="server" Width="50px"></asp:TextBox>
            </td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #F5F5F6">
                Type*:</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                <asp:DropDownList ID="DropDownList1" runat="server" Width="150px">
                </asp:DropDownList>
            </td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #F5F5F6">
                <span id="lblPc_ccard_T_7" class="black">Expiry Date</span>:</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
&nbsp;</td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #F5F5F6">
                <span id="lblPc_ccard_T_8" class="black">Bank Name</span>*:</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                <dx:ASPxTextBox ID="ASPxTextBox2" runat="server" Width="300px">
                </dx:ASPxTextBox>
            </td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #F5F5F6">
                <span id="lblPc_ccard_T_9" class="black">Amount Due</span>*:</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                &nbsp;</td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; background-color: #F5F5F6">
                &nbsp;</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                &nbsp;</td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td class="bold" 
                style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #E4E4E4">
                CARD HOLDER DETAILS</td>
            <td class="reginput" style="width: 280px; background-color: #E4E4E4">
                &nbsp;</td>
            <td style="background-color: #E4E4E4">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; background-color: #F5F5F6">
                &nbsp;</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                &nbsp;</td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #F5F5F6">
                <span id="lblPc_ccard_T_11" class="black">eMail</span>*:
            </td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                <dx:ASPxTextBox ID="ASPxTextBox3" runat="server" Width="300px">
                </dx:ASPxTextBox>
            </td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #F5F5F6">
                <span id="lblPc_ccard_T_12" class="black">Phone Number </span>*:</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                <dx:ASPxTextBox ID="ASPxTextBox4" runat="server" Width="300px">
                </dx:ASPxTextBox>
            </td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; background-color: #F5F5F6">
                &nbsp;</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                &nbsp;</td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td class="bold" 
                style="width: 200px; color: #2D3E5C; font-family: Verdana; background-color: #E4E4E4">
                AGREEMENT</td>
            <td class="reginput" style="width: 280px; background-color: #E4E4E4">
                &nbsp;</td>
            <td style="background-color: #E4E4E4">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px; background-color: #F5F5F6">
                &nbsp;</td>
            <td class="reginput" style="width: 280px; background-color: #F5F5F6">
                &nbsp;</td>
            <td style="background-color: #F5F5F6">
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px">
                &nbsp;</td>
            <td class="reginput" style="width: 280px">
                &nbsp;</td>
            <td>
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
        <tr>
            <td style="width: 179px">
                &nbsp;</td>
            <td style="width: 200px">
                &nbsp;</td>
            <td class="reginput" style="width: 280px">
                &nbsp;</td>
            <td>
                &nbsp;</td>
            <td>
                &nbsp;</td>
        </tr>
    </table>
</asp:Content>

